TY - JOUR
T1 - Treatment burden in people with hypertension is correlated with patient experience with self-management
AU - Rogers, Elizabeth A.
AU - Abi, Hani
AU - Linzer, Mark
AU - Eton, David T.
N1 - Funding Information:
Funding: DTE’s work was supported by the National Institute of Nursing Research of the National Institutes of Health (NIH) under award number R21NR012984. EAR was supported through award number K23DK118207 from the NIH National Institute of Diabetes and Digestive and Kidney Diseases. HA was supported through the UMN CTSI’s Pathways to Research Program (NIH NCATS award number UL1TR002494). The content is solely the responsibility of the
Funding Information:
DTE?s work was supported by the National Institute of Nursing Research of the National Institutes of Health (NIH) under award number R21NR012984. EAR was supported through award number K23DK118207 from the NIH National Institute of Diabetes and Digestive and Kidney Diseases. HA was supported through the UMN CTSI?s Pathways to Research Program (NIH NCATS award number UL1TR002494). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. ML is supported in his work at Hennepin Healthcare on burnout reduction by the American Medical Association, the American College of Physicians, the American Board of Internal Medicine, and the Institute for Healthcare Improvement. He is also supported by the NIH and the Agency for Healthcare Research and Quality (AHRQ) and consults on a grant for Harvard University on clinician work conditions and diagnostic accuracy. He has received honoraria for Medical Grand Rounds from Harvard University, the University of Chicago, and Montefiore Medical Center in the past 3 years.
Funding Information:
authors and does not necessarily represent the official views of the National Institutes of Health. ML is supported in his work at Hennepin Healthcare on burnout reduction by the American Medical Association, the American College of Physicians, the American Board of Internal Medicine, and the Institute for Healthcare Improvement. He is also supported by the NIH and the Agency for Healthcare Research and Quality (AHRQ) and consults on a grant for Harvard University on clinician work conditions and diagnostic accuracy. He has received honoraria for Medical Grand Rounds from Harvard University, the University of Chicago, and Montefiore Medical Center in the past 3 years. Conflict of interests: No conflicts of interest reported.
Publisher Copyright:
© 2021 American Board of Family Medicine. All rights reserved.
PY - 2021/11
Y1 - 2021/11
N2 - Introduction: New hypertension guidelines in the United States may require more people to take multiple medications or implement lifestyle changes. Increased treatment burden may be an unintended consequence and lead to worse health outcomes. Our study examined whether treatment burden is associated with factors related to self-management in those with hypertension. Methods: We conducted a cross-sectional mailed survey of patients from 2 medical centers in Minnesota. Participants with 2 or more medical conditions completed the Patient Experience with Treatment and Self-management (PETS), a validated treatment burden questionnaire, as well as measures of confidence in self-management ability, health literacy, health care-related financial difficulties, and perception of provider interpersonal skills. We used partial correlation analyses, controlling for age, sex, race, and education, to test relationships among study variables. Results: Of 254 respondents who had a diagnosis of hypertension, 54% were female, 74% were non-Hispanic White, and the mean age was 67 years. People with hypertension who reported having lower confidence in self-management ability, lower health literacy, more financial difficulties, and health care providers with poorer interpersonal skills reported higher treatment burden scores (PETS scales correlation magnitude range 0.09 to 0.62, P < .05 on all but 4). The strongest associations were observed for medical information and physical/mental exhaustion with self-management (correlation magnitudes from 0.25 to 0.54, P < .01). Discussion: Hypertension treatment guideline stringent blood pressure criteria may lead to more interventions—medical or lifestyle—creating strains on populations already challenged by abstract disease self-management and at risk of experiencing disparities in cardiovascular health outcomes.
AB - Introduction: New hypertension guidelines in the United States may require more people to take multiple medications or implement lifestyle changes. Increased treatment burden may be an unintended consequence and lead to worse health outcomes. Our study examined whether treatment burden is associated with factors related to self-management in those with hypertension. Methods: We conducted a cross-sectional mailed survey of patients from 2 medical centers in Minnesota. Participants with 2 or more medical conditions completed the Patient Experience with Treatment and Self-management (PETS), a validated treatment burden questionnaire, as well as measures of confidence in self-management ability, health literacy, health care-related financial difficulties, and perception of provider interpersonal skills. We used partial correlation analyses, controlling for age, sex, race, and education, to test relationships among study variables. Results: Of 254 respondents who had a diagnosis of hypertension, 54% were female, 74% were non-Hispanic White, and the mean age was 67 years. People with hypertension who reported having lower confidence in self-management ability, lower health literacy, more financial difficulties, and health care providers with poorer interpersonal skills reported higher treatment burden scores (PETS scales correlation magnitude range 0.09 to 0.62, P < .05 on all but 4). The strongest associations were observed for medical information and physical/mental exhaustion with self-management (correlation magnitudes from 0.25 to 0.54, P < .01). Discussion: Hypertension treatment guideline stringent blood pressure criteria may lead to more interventions—medical or lifestyle—creating strains on populations already challenged by abstract disease self-management and at risk of experiencing disparities in cardiovascular health outcomes.
KW - Cardiovascular diseases
KW - Chronic disease
KW - Cross-sectional studies
KW - Disease management
KW - Hypertension
KW - Minnesota
KW - Patient-reported outcome measures
KW - Questionnaires
KW - Self-management
KW - Surveys
UR - http://www.scopus.com/inward/record.url?scp=85120339858&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85120339858&partnerID=8YFLogxK
U2 - 10.3122/JABFM.2021.06.210191
DO - 10.3122/JABFM.2021.06.210191
M3 - Article
C2 - 34772780
AN - SCOPUS:85120339858
VL - 36
SP - 1243
EP - 1245
JO - Journal of the American Board of Family Medicine
JF - Journal of the American Board of Family Medicine
SN - 1557-2625
IS - 4
ER -